Science and Research Committee on Oct. 8th, 2025

[Dr. Victor Leung]

Overall, with budget cuts, the first thing that may likely happen is a decrease in progress towards advancing what was previously committed to. However, I think that with budget cuts also comes an opportunity to relook at how programs have developed and at whether or not there are opportunities to do things within the fiscal constraints, such as creating new processes, which often are not as expensive as creating access to drugs. At the end of the day, current drug access is often limited by inefficient and outdated processes. It's not necessarily all tied to the financial costs of procurement for some of these drugs.

Fiscal constraints will force us to really consider more efficient and innovative processes that have been tried by other G7 countries and that may not result, necessarily, in increased upfront costs. At least, at the end of the day, even if the upfront costs are higher, the return on investment.... If the process is established to be efficient, usable and practical for the end users, we will still, for now, be able to work within solutions that are allocated to the various groups to make these drugs accessible.

[Jagsharan Singh Mahal, Conservative, Edmonton Southeast, AB]

Thank you for your answer, Doctor.

When you answered my colleague's question, I did not understand it clearly. She asked you what the risk is of doctors and nurses getting those AMR infections transmitted to them while they are on duty. How do you think the federal government and those concerned are doing with regard to protection of those doctors and nurses working on the front line?

[Dr. Victor Leung]

Health care workers, when dealing with patients with antimicrobial-resistant infections, are going to be at risk as transiently colonized, meaning that it becomes part of some aspect of their body—for example, the skin—but they may not be infected with it. They can then also act as a potential for transmitting to other individuals. That is why it's fundamental to have infection prevention and control measures within facilities, as well as proper occupational health approaches.

When it comes to occupational health approaches, we saw, for example, with the COVID pandemic, some of the challenges in thinking about what our best allocation of resources is to focus on the prevention of acquiring or transmitting an infection. It doesn't have to come down to only personal protective equipment.

I think an aspect of hospitals that we should be more focused on as we modernize infrastructure is engineered infection prevention and control measures, which don't rely, necessarily, on the individual health care worker being aware of some of the ways that infection is transmitted—for example, infections that are transmitted through the air or infections that are transmitted through surfaces. There is an increasing number of useful, cost-effective, engineered infection prevention and control measures that can be incorporated in new hospital builds and also retrofitted into some older facilities.

[Jagsharan Singh Mahal, Conservative, Edmonton Southeast, AB]

You also mentioned that—

You also mentioned that—

[The Chair, Liberal, Salma Zahid]

Your time is up, Mr. Mahal.

Your time is up, Mr. Mahal.

[Jagsharan Singh Mahal, Conservative, Edmonton Southeast, AB]

Can I have that in writing? I have just one question.

[The Chair, Liberal, Salma Zahid]

If something comes up, like another round or something, we will see. Otherwise, we can deal with it at the end.

Now we proceed to MP Noormohamed for five minutes. Please go ahead.

[Taleeb Noormohamed, Liberal, Vancouver Granville, BC]

Thank you, Madam Chair.

Thank you to our witnesses for being here. I have a question for all three of you. I'll start with Dr. Otto, then Dr. McGeer and then Dr. Leung.

Dr. Otto, you spoke about the importance of vaccinations, vaccines and vaccine development. We have seen, over the course of the last little while, an alarming rate of vaccine hesitancy and criticism of the use of vaccines, including from politicians. That, I would argue, causes a substantial amount of public concern, which then leads to a distrust of science. In this time—as you were talking about—of antibiotic resistance, and with the need, now, to urgently and quickly develop new vaccines and to get those vaccines to people, particularly to those who are on the front lines of some of these emerging illnesses and diseases, what would you say to the politicians and to those who are spreading some of this misinformation about vaccines?

[Dr. Simon Otto]

I think it's twofold. We need to focus on the messaging that vaccines do work—they are not going to prevent infection from happening, but they're going to reduce disease and transmission at the population level—and on reinforcing the messaging about vaccine safety. This isn't just for human medicine: Vaccines are incredibly important for veterinary medicine, the animal health side, as well.

I am going to reiterate my point about research around the social science piece, because it's not just the political side. The human population is now quite reluctant because of messaging around vaccines and misinformation. I think we need to fill that void with the scientific evidence, but we need to do it in a way that's digestible for people as opposed to reverting to the stats and technical pieces. In the research piece around siloing, and “one health” as well, our research agencies, federally, are set up to fund human medical research, science, STEM, animal health and social science, and it creates a split, making it difficult for some of that one health research across those spaces to tackle some of these problems.

[Taleeb Noormohamed, Liberal, Vancouver Granville, BC]

Thank you.

Dr. McGeer, the same questions....

[Dr. Allison McGeer]

I think there are three things. The first is that, yes, there's been a substantial impact, but we're still doing pretty well with vaccines. Under the Ontario vaccine program for RSV—which, you would have thought, in the middle of COVID, flu and general catastrophe, would have been really difficult and was started way too late—we vaccinated 70% of residents in long-term care facilities. That we can do that is an amazing testament to the people who work in long-term care and the families of people in long-term care. Yes, we need to be worried about vaccines, but we don't need to be panicking about the state of vaccines.

The second thing about vaccines is that, partly because they're prevention.... You know how hard it is to value prevention. I've spent my life in infection prevention, and do you know what a really good day in infection prevention is? It's a day when nothing happens. Pitching that to my CEO is really hard, so vaccines are hard, because they're part of prevention.

They're also hard because of the neuroscience, of thinking about taking risks for future benefit. A piece of this is that we will never get away from vaccine hesitancy and misinformation. It's been with us since the 1700s, when Jenner first started. It will be with us 400 years from now unless we get past vaccines in some fundamental way.

A piece of it is that we just need to keep working at it, but you're absolutely right that what we need now, particularly with what's going on south of us, is a real focus on what we can do to protect people from disinformation, in particular younger people, who don't have the faith in vaccines that we older folks have, and who also consume much more of the social media in which disinformation is spreading. It's a very significant issue that we need to focus on.

[Taleeb Noormohamed, Liberal, Vancouver Granville, BC]

Thank you.

I turn it over to you, Dr. Leung.

[Dr. Victor Leung]

I would say, specifically for the vaccines, that even though we sometimes think it may be vaccine hesitancy, the more common problems I encounter, for people who are underimmunized for things they are eligible for, are awareness and access. There are lots of barriers to vaccine access across the country, based on how it's currently funded. A lot of the time.... Specifically, for example, the program that we started at our hospital for vaccination against zoster, a reactivation of chicken pox, is funded by the first nations health benefits program, but the logistics around getting it are the barrier, not the people's willingness to get the vaccine.

[The Chair, Liberal, Salma Zahid]

We will proceed to MP Blanchette-Joncas for two and a half minutes.

Please go ahead.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

Dr. Otto, the report by Policy Horizon Canada, “Disruptions on the Horizon,” states that antimicrobial resistance has become the leading cause of mortality in the world and that it is already disrupting food systems. You're working on the “farm to fork” strategy. To what extent does the underfunding of science and research by the federal government weaken our ability to meet this challenge?

[Dr. Simon Otto]

I think my comments are not specific to government. Our challenge of understanding farm-to-fork transmission is hampered by the gaps in our surveillance program, which are not specific to this government. Those programs have been well designed by thoughtful people, but budgets that predated the current government and past governments have continually created challenges for them in terms of expanding those programs.

As I mentioned, I think there are gaps in understanding there. While we have a world-renowned system in terms of its design, the big gaps are in terms of coverage, animal health, animal pathogens and the areas that I mentioned in my testimony earlier.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

What tangible measures do you wish to see in the next budget, the one coming out in November, to tackle the global challenge of antimicrobial resistance?

[Dr. Simon Otto]

What we've seen with surveillance budgets over the last 10 to 15 years is that they have continually been decreased, to the point that the programs are being run by a relatively small number of experts in the space without a lot of supporting cast there. There needs to be investment in the personnel to support the programs and also to expand their coverage.

If you look at animal pathogens, for example, on the AMR side, the majority of animal pathogen surveillance is currently funded by research funding as opposed to ongoing budget funding. That's a specific area that would help.

I mentioned—and Dr. McGeer and Dr. Leung can speak more to this—AMR surveillance in long-term care and the community side to have a better understanding of the human-medical piece. Those are currently funded as pilot projects, but they need to be expanded to more mainstream surveillance programs.

Then there is addressing how we work with provincial data to get some more integration with the provincial data sources that exist, which Dr. Leung spoke to.

[The Chair, Liberal, Salma Zahid]

Thank you.

The time is up for MP Blanchette-Joncas.

We will have one and a half minutes each for the Conservatives and the Liberals. Then the panel will come to an end.

Mr. Baldinelli is on the list. I don't know if Mr. Mahal wants to ask his question.

[Tony Baldinelli, Conservative, Niagara Falls—Niagara-on-the-Lake, ON]

I'll take this opportunity.

I just want to thank the witnesses for being with us today.

Dr. McGeer, in your opening comments you said you're going to discuss what it is we are not doing right. One of those things that you talked about was transmissions within hospitals. I think you said—it was kind of shocking—that it's “the crucible” for AMR.

Do poor health care practices like overcrowding in our hospitals and hallway health care increase the risk and acceleration of AMR in Canada?

[Dr. Allison McGeer]

The answer to that is yes, but it's more fundamental than that.

Even our best, newest hospitals, with what people are doing as current best practice, have not effectively reduced transmission of AROs in the hospital.

Organizing yourself to do that is difficult. It requires an investment of funds on the part of the hospital, which is hard for hospitals to do. Crowding, shortages of staff and less space unquestionably make it worse, but we have a core problem that is beyond that.

[Tony Baldinelli, Conservative, Niagara Falls—Niagara-on-the-Lake, ON]

Dr. Leung, you said in your opening remarks that Canada is “falling behind” in terms of the antimicrobials that are available. In fact, in our excellent note that was prepared by our staff—and Dr. Salama mentioned this the other day—from 2010 really to 2021, only three out of 18 new antibiotics launched worldwide are available in Canada. You talked about some of the approval processes.

[The Chair, Liberal, Salma Zahid]

Your time is up, Mr. Baldinelli.

[Tony Baldinelli, Conservative, Niagara Falls—Niagara-on-the-Lake, ON]

Could you just provide written comments on some of your concerns with the Health Canada special access program and how that could be improved?

[The Chair, Liberal, Salma Zahid]

Thank you.

We will now proceed to MP McKelvie for one and a half minutes before we end this panel.